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Evaluating the impact of coronavirus disease 2019 on asthma morbidity: A comprehensive analysis of potential influencing factors.
Ann Allergy Asthma Immunol. 2021 07; 127(1):91-99.AA

Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic period is experiencing better asthma control, fewer exacerbations, and health care utilization, with limited data on factors that could explain this phenomenon.

OBJECTIVE

To confirm these improved asthma outcomes during COVID-19 and evaluate potential contributing factors.

METHODS

In 18,912 pediatric patients with asthma treated in the Children's Hospital of Orange County network from 2017 to 2020, monthly asthma-related encounters and medication summaries were extracted from electronic health records, particulate matter 2.5 (PM2.5) air pollution from the California Air Resources Board, and influenza-like illness from Illness Surveillance Network for the first 6 months of each year. Changes in outcomes between January to March and April to June (post-COVID-19 shutdown in 2020) were compared with historical data using generalized estimating equations analyses for patient outcomes and generalized linear models for pollution exceedance, influenza-positive, and telehealth visit rates.

RESULTS

During COVID-19, we found 78%, 90%, 68% reductions in hospitalization, emergency department visits, and exacerbations, respectively, compared with pre-COVID-19 2020, with significantly greater changes than the same time period of 2017 to 2019 and significant reductions in albuterol and inhaled corticosteroid use (P < .05). Emergency department visit reduction was not seen for African Americans. The PM2.5 and influenza rates were also significantly reduced during COVID-19 (P < .05). Increased rates in telehealth visits were greater in the publicly insured group when compared with commercially insured.

CONCLUSION

Our data confirm reduced health care utilization and suggest better asthma control during COVID-19, except for African Americans. This was associated with a significant increase in telehealth visits and reductions in PM2.5 and influenza infections, but not better asthma controller adherence.

Authors+Show Affiliations

Children's Hospital of Orange County (CHOC), Orange, California. Electronic address: oguijon@choc.org.Children's Hospital of Orange County (CHOC), Orange, California; Morphew Consulting, LLC, Bothell, Washington.Children's Hospital of Orange County (CHOC), Orange, California; Chapman University, Orange, California.Children's Hospital of Orange County (CHOC), Orange, California; Irvine School of Medicine, University of California, Irvine, California.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33775900

Citation

Guijon, Olga L., et al. "Evaluating the Impact of Coronavirus Disease 2019 On Asthma Morbidity: a Comprehensive Analysis of Potential Influencing Factors." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 127, no. 1, 2021, pp. 91-99.
Guijon OL, Morphew T, Ehwerhemuepha L, et al. Evaluating the impact of coronavirus disease 2019 on asthma morbidity: A comprehensive analysis of potential influencing factors. Ann Allergy Asthma Immunol. 2021;127(1):91-99.
Guijon, O. L., Morphew, T., Ehwerhemuepha, L., & Galant, S. P. (2021). Evaluating the impact of coronavirus disease 2019 on asthma morbidity: A comprehensive analysis of potential influencing factors. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 127(1), 91-99. https://doi.org/10.1016/j.anai.2021.03.018
Guijon OL, et al. Evaluating the Impact of Coronavirus Disease 2019 On Asthma Morbidity: a Comprehensive Analysis of Potential Influencing Factors. Ann Allergy Asthma Immunol. 2021;127(1):91-99. PubMed PMID: 33775900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluating the impact of coronavirus disease 2019 on asthma morbidity: A comprehensive analysis of potential influencing factors. AU - Guijon,Olga L, AU - Morphew,Tricia, AU - Ehwerhemuepha,Louis, AU - Galant,Stanley P, Y1 - 2021/03/26/ PY - 2021/01/20/received PY - 2021/03/05/revised PY - 2021/03/18/accepted PY - 2021/3/30/pubmed PY - 2021/7/1/medline PY - 2021/3/29/entrez SP - 91 EP - 99 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann Allergy Asthma Immunol VL - 127 IS - 1 N2 - BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic period is experiencing better asthma control, fewer exacerbations, and health care utilization, with limited data on factors that could explain this phenomenon. OBJECTIVE: To confirm these improved asthma outcomes during COVID-19 and evaluate potential contributing factors. METHODS: In 18,912 pediatric patients with asthma treated in the Children's Hospital of Orange County network from 2017 to 2020, monthly asthma-related encounters and medication summaries were extracted from electronic health records, particulate matter 2.5 (PM2.5) air pollution from the California Air Resources Board, and influenza-like illness from Illness Surveillance Network for the first 6 months of each year. Changes in outcomes between January to March and April to June (post-COVID-19 shutdown in 2020) were compared with historical data using generalized estimating equations analyses for patient outcomes and generalized linear models for pollution exceedance, influenza-positive, and telehealth visit rates. RESULTS: During COVID-19, we found 78%, 90%, 68% reductions in hospitalization, emergency department visits, and exacerbations, respectively, compared with pre-COVID-19 2020, with significantly greater changes than the same time period of 2017 to 2019 and significant reductions in albuterol and inhaled corticosteroid use (P < .05). Emergency department visit reduction was not seen for African Americans. The PM2.5 and influenza rates were also significantly reduced during COVID-19 (P < .05). Increased rates in telehealth visits were greater in the publicly insured group when compared with commercially insured. CONCLUSION: Our data confirm reduced health care utilization and suggest better asthma control during COVID-19, except for African Americans. This was associated with a significant increase in telehealth visits and reductions in PM2.5 and influenza infections, but not better asthma controller adherence. SN - 1534-4436 UR - https://www.unboundmedicine.com/medline/citation/33775900/Evaluating_the_impact_of_coronavirus_disease_2019_on_asthma_morbidity:_A_comprehensive_analysis_of_potential_influencing_factors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1081-1206(21)00219-2 DB - PRIME DP - Unbound Medicine ER -